( continued from page 23) clear how the recent change in the political climate in Washington will affect MACRA. Congress, through MACRA, has once and for all finally put an end to fee-for-service health care delivery. Physicians and their assistants will be going from their present setting of seeing more patients for less, to one of working more while also being at considerable financial risk. They will both have the required“ skin in the game” with health systems, MCO’ s and other provider based health care organizations. All the financial elasticity will be gone from the health care delivery system. Physicians and health care providers may not be able work more hours or any harder. However, this new environment created by MACRA health care funding requires that all physicians and physician assistants will need to learn to work much smarter.
Poverty and other health care disparities have always been prime indicators of health. Employment improves health without any specific medical care cost and does not generally require the provision of health care. The unemployed enjoy better health when looking for work or taking job training. There is also some suggestion that community involvement improves health. Training programs should be designed to teach our physician assistants how to help patients deal with all these important health related issues. Physician assistants must be educated and skilled in dealing with the social issues of addiction, obesity, stress and the environment. Mid-level health care providers will need to understand how science-based medicine should be applied to all health care. Physicians and physician assistants should also understand that the health plan of the future must be designed to target all unengaged health care consumers. A“ big box store greeter” may be needed to become part of the health care delivery team to triage patients in order to meet this need. Physician assistants as health care providers must learn how to document care and to understand the importance of the electronic health and medical record. They must be system thinkers who do not view performance reporting as just another example of“ processing” irritants / grief. Physician assistants and their sponsoring responsible physicians must also be proactive when providing a value-added medical home for all of their panel of patients. A medical home should have a positive impact on the reduction of low quality and high cost unscheduled clinic visits, emergency room visits and hospital readmissions.
The future as a health care provider looks bright for physician assistants and all other physician extenders. There should be many open positions for the employment of trained, certified and licensed individuals interested and willing to do clinical practice as part of a health care delivery team. Health care management positions will be available to physician assistants who have other advanced degrees, training, people skills and leadership experiences. There will also be more opportunities coming available for interested physicians presently in practice to become chairpersons, program directors, professors and medical directors at universities and colleges offering a master’ s degree program in physician assistant studies. The future manpower issue that some health care planners are working on is the concept of a six year medical school. It may be that the velocity of change will demand that the nearly 200 accredited physician assistant schools that are already in place be utilized to meet this projected manpower need.
Dr. Henderson is a clinical professor at the University of Louisville School of Medicine, Department of Pediatrics.
PROFESSIONAL ANNOUNCEMENT PACKAGE
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Are you opening a new satellite office?
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The GLMS Professional Announcement Package provides mailings and printed announcements in the monthly publications to let your colleagues know about changes in your practice.
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CONTACT Cheri McGuire, Director of Marketing 502.736.6336 cheri. mcguire @ glms. org
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